Bone density at interradicular sites: implications for orthodontic mini‐implant placement

Authors – Chun YS, Lim WH Objectives – Implant stability is primarily related to local bone density; Few studies have evaluated interradicular bone density related to mini‐implant placement for orthodontic anchorage. Therefore, this study evaluated bone density differences between interradicular sites. Setting and Sample Population – Computed tomographic (CT) images were obtained from 14 males and 14 females (mean age 27 years, range 23–35 years). Bone density in Hounsfield units (HU) was measured at 13 interradicular sites and four bone levels. Results – Bone densities in most areas were higher than 850 HU. Statistically significant differences in bone density were detected at different levels and sites. Bone densities in both maxilla and mandible significantly increased from the alveolar crest toward basal bone in posterior areas, while the opposite was observed in anterior areas. There were statistically significant differences in bone densities between the maxilla and mandible in posterior areas. Bone densities progressively increased from anterior to posterior areas in the mandible. Conclusion – The results suggest that mini‐implants for orthodontic anchorage may be effective when placed in most areas with equivalent bone density up to 6 mm apical to the alveolar crest. Site selection should be adjusted according to bone density assessment.     

牙龈乳头尖作为微种植钉植入标志的测量分析

目的探讨上颌第二前磨牙与第一磨牙间（U56）及下颌第一磨牙与第二磨牙间（L67）,颊侧牙龈乳头尖到牙槽嵴顶距离在不同年龄段及男女性别之间的差异性,研究牙龈乳头尖能否作为微种植钉植入的软组织解剖标志。方法选取多层螺旋CT（MSCT）三维重建影像资料88例,分为青少年男性组、青少年女性组、成年男性组和成年女性组,每组22例,测量颊侧牙龈乳头尖到牙槽嵴顶的距离,并对测量结果进行统计学分析。结果上颌第二前磨牙与第一磨牙间及下颌第一磨牙与第二磨牙间,颊侧牙龈乳头尖到牙槽嵴顶的距离：（1）两部位牙龈乳头尖到牙槽嵴顶的距离较为恒定,约4.2 mm;（2）青少年组与成年组之间,在各水平的颊侧牙龈乳头尖到牙槽嵴顶的距离差异无统计学意义（P＞0.05）;（3）男性组与女性组之间,在各水平的颊侧牙龈乳头尖到牙槽嵴顶的距离异无统计学意义（P＞0.05）。结论在上颌第二前磨牙与第一磨牙间及下颌第一磨牙与第二磨牙间,颊侧牙龈乳头尖到牙槽嵴顶距离恒定,可以作为微种植钉植入的参考点。     

Evaluation of Hard and Soft Tissue Dimensions Around Zirconium Oxide Implant–Supported Crowns: A 1‐Year Retrospective Study

Background: This study aims to evaluate the effect of the distance between the alveolar crest of a full‐ceramic implant to the lowest point of the contact area of the crowns on the interdental papilla. Therefore, the authors proposed a new concept of linear measurements for the reproducible and metric evaluation of distances relevant for the assessment of hard and soft tissue changes around dental implants. Methods: A total of 216 sites were examined in 87 patients. In a radiographic and clinical evaluation, four relevant distances were evaluated. In the x‐ray image, the tip of the papilla was marked with a radiodense mixture of tungsten powder and temporary cement. In a clinical photograph, the lowest point of the interdental contact zone of the crowns was visualized by a metallic interdental ligature. Results: Using the proposed measuring methodology, four different papilla‐deficit situations around ceramic implants could be reproducibly distinguished. When the measurement from the bone crest at the implant was ≤5 mm, the papilla was completely present in 100% of cases. When this distance was 10 mm, the papilla was still present in 67% of the cases, without any cosmetically apparent deficit. Conclusions: A close relationship is observed between the distance from the contact point to the bone and the presence of the papilla. Using a combination of radiographically and clinically visible landmarks allows the reproducible measurement of these distances.     

Localized Management of Sinus Floor Technique for Implant Placement in Fresh Molar Sockets

Background: The use of osteotome for vertical bone augmentation and localized sinus elevation with minimal surgical trauma represents a suitable procedure to increase the vertical dimension of available bone for implant placement. Purpose: The aim of this study was to report clinical and radiographic results of localized management of sinus floor (LMSF) in fresh molar sockets at 13‐year follow‐up. Materials and Methods: Fifty‐three patients, needing one or two maxillary molar extraction, were enrolled in this study. LMFS procedure was performed and 68 implants were positioned. A presurgical distance from the alveolar crest to the floor of the maxillary sinus and the amount of new radiopacity between the sinus floor and alveolar crest were measured from the mesial and distal surfaces of each dental implant surface. Results: After a mean follow‐up period of 9.76 ± 5.27 years (ranged from 4 to 17 years) a survival rate of 100% was reported. Mean bone height at temporary prosthesis placement was 7.99 ± 1.16 mm. They were stable over time, reporting a mean value of 8.01 ± 1.46 mm at 13‐year follow‐up. Conclusions: The results of this study demonstrated that LMSF procedure in fresh molar sockets allowed to expand the dimensions of resorbed posterior maxillary alveolar bone both vertically and horizontally with a success rate of 100% of implant osseointegration over time.     

Comparison of cortical bone thickness and root proximity at maxillary and mandibular interradicular sites for orthodontic mini‐implant placement

Authors – Lim JE, Lee SJ, Kim YJ, Lim WH, Chun YS Objectives – To compare maxillary and mandibular cortical bone thickness and rootic proximity for optimal mini‐implant placement. Setting and Sample Population – CT images from 14 men and 14 women were used to evaluate buccal interradicular cortical bone thickness and root proximity from mesial of the central incisor to the 2nd molar. Cortical bone thickness was measured at 0°, 15°, 30°, and 45° angles relative to the root surface using three‐dimensional images. Results – For the cortical bone thickness, there was no statistically significant difference between the maxilla and the mandible in the anterior area; however, there was a significant difference in the posterior area. Cortical bone in the maxilla, mesial and distal to canine interradicular sites, was thickest while thickness in the mandible exhibited a gradual anterior to posterior increase. Cortical bone thickness in the maxilla increased as both level and angle increased, while the cortical bone thickness in the mandible was greatest at 4 mm from the alveolar crest. Root proximity mesial and distal to 2nd premolar interradicular sites was greatest. Conclusion – Based on our results, cortical bone thickness depends on the interradicular site rather than sex or individual differences.     

Placement of endosseous implants into bone-grafted alveolar clefts: assessment of bone bridge after autogenous particulate cancellous bone and marrow graft

The objective of this study was to evaluate the bone quantity of alveoli grafted with autogenous particulate cancellous bone and marrow for implant placement in patients with alveolar clefts. Bone height, bone width, and interdental alveolar crest level were evaluated using computed tomography and periapical radiographs. The grafted alveoli underwent resorption 3-dimensionally, and the interdental alveolar crest level also decreased. The latter seemed to be the critical factor for implant surgery, as almost half of the grafted alveoli required another bone graft within 24 months after the original bone graft to increase the interdental alveolar crest level for endosseous implant placement. These data suggest that alveoli grafted with particulate cancellous bone and marrow are suitable for implant placement, but that the loss of width and height of the bone bridge must also be considered.     

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目的对上颌前牙区颌骨的骨量及唇侧骨皮质厚度进行测量分析,为正畸治疗植入微种植支抗钉的安全区提供参考依据。方法对2010年9月至2011年6月来大连市口腔医院就诊的25例成人患者行锥形束CT扫描及三维重建,测量距上颌牙槽嵴顶3、6、9、12mm4个水平上颌中切牙、侧切牙、尖牙根间区近远中向、唇腭向的距离以及唇侧骨皮质厚度。结果 (1)在距上颌牙槽嵴顶3、6、9mm水平中切牙根间近远中向距离均最宽,唇侧骨皮质均最薄;(2)在距牙槽嵴顶9mm水平中切牙与侧切牙根间近远中向距离最窄;(3)在4个测量水平侧切牙与尖牙根间唇侧骨皮质均最厚;(4)唇腭向在距牙槽嵴顶9mm及以上水平,中切牙根间骨厚度最薄,中切牙与侧切牙根间骨厚度最厚。25例中仅3例前牙区各牙根长度超过12mm,在距牙槽嵴顶12mm水平能测出根间近远中向距离,均较宽。结论通过对扫描后颌骨影像的分析,明确了前牙区颌骨的骨量及唇侧骨皮质厚度,为植入微种植支抗钉的安全区提供参考依据。     

Evaluation of the Effects of Buccal–Palatal Bone Width on the Incidence and Height of the Interproximal Papilla Between Adjacent Implants in Esthetic Areas

Background: The presence of interproximal papilla depends on the distance between the contact point to the bone crest, as well as the mesio‐distal distance between implants or between implants and teeth. The aim of this study is to evaluate the effects of buccal–palatal bone width on the presence of the interproximal papilla between adjacent implants in esthetic areas of the mouth. Methods: The presence or absence of the gingival papilla, distance from the base of the interproximal contact to the tip of the gingival papilla (black space), distance from the base of the interproximal contact to the alveolar crest (vertical distance), alveolar bone width (bone width) between adjacent implants as well as the spacing between the implants (horizontal distance), and soft‐tissue biotype were assessed in 29 interimplant areas in the upper incisor, canine, and premolar regions of 18 patients. Results: The papilla was always present when vertical distance was ≤5 mm (P ≤0.04) and frequently present when the horizontal distance was ≥4 mm (P = 0.04). The black space was smaller when the vertical distance was ≤5 mm (P ≤0.04) and when the horizontal distance was ≥4 mm (P = 0.76). Bone width and soft‐tissue biotype did not influence the incidence of gingival papilla (P ≥0.41) and black space (P ≥0.15). Conclusion: Within the limits of this study, it can be concluded that bone width and tissue biotype do not have an effect on the incidence and height of papilla between adjacent implants in esthetic areas, and the incidence was greater when vertical distance was ≤5 mm or when horizontal distance was ≥4 mm.     

Osseous proliferation of the mandible after placement of endosseous implants

Spontaneous alveolar ridge growth in the posterior region of the mandible following placement of endosseous implants is reported. The study included 27 patients with totally edentulous mandibles and fixed prostheses supported by osseointegrated implants placed between the mental foramina. In 5 patients, an increase in the height of the alveolar crest was observed in the molar region; the increase ranged from 3.3% to 8.6%. This osseous proliferation may be a physiologic response to stress distribution in the molar region.     

Morphometric study of the interproximal unit in the esthetic region to correlate anatomic variables affecting the aspect of soft tissue embrasure space

BACKGROUND: The presence of a normal papilla is crucial to avoid the unpleasant esthetic defects that are of major concern to periodontists, restorative dentists, and patients. During the course of progressive periodontitis and following periodontal treatment, it is not uncommon to have a partial loss of the interdental papilla. This loss can lead to an unesthetic gingival appearance. This study evaluated different anatomic variables in an effort to determine their role in the papillary appearance of maxillary incisors. METHODS: A total of 178 interdental embrasures in 58 patients were selected randomly for examination. For each patient, a digital photograph and a modified periapical radiograph of the interdental embrasure of the four maxillary incisors were taken by using a special metric device fixed to a centrator as a reference marker. Clinical and radiographic data were obtained for the distance from the contact point to the alveolar crest and for the interradicular distance. We used a classification system with regard to peri-implant soft tissue based on esthetic assessments related to the space between reference lines through the highest gingival curvature of the crown-tooth margin and the contact point. RESULTS: In the group of interdental sites with an interradicular distance of less than approximately 2.4 mm, an increase in the distance between the contact point and the bone crest corresponded to a marked increase in the interdental black triangle's dimensions and, therefore, a less esthetic smile. In particular, when the interradicular distance was >2.4 mm, we statistically estimated that the other anatomic variable considered, the distance from the contact point to the alveolar crest, lost its influence on whether the interdental papilla would be present or absent. CONCLUSION: The interradicular distance and the distance between the contact point and the alveolar crest have independent and combined effects on the presence or absence of the interdental papilla.     

The effects of interproximal distance between roots on the existence of interdental papillae according to the distance from the contact point to the alveolar crest

BACKGROUND: This study investigated the existence of interdental papillae at certain distances from the contact point to the alveolar crest, depending on the interproximal distance between roots. METHODS: A total of 206 papillae from 80 patients were examined after the inflammation of the papillae had been minimized using non-surgical periodontal therapy. The existence of the interdental papillae was determined using the following categorization: 1) papillae were deemed to be absent if they did not extend all the way up to the contact point between the teeth; and 2) papillae were determined to be present if they filled up to the entire proximal space. The interproximal distance between roots and the distance from the contact point to the alveolar crest were measured when a full-thickness flap was used. The number of papillae present interproximally between roots, according to the distance from the contact point to the alveolar crest, was analyzed using the x2 analysis method, and the linear-by-linear association analysis method was used for trend analysis. RESULTS: The number of papillae that filled the interproximal space decreased with increasing distance from the contact point to the alveolar crest (P <0.05). In addition, the number of papillae that filled the interproximal space decreased with increasing interproximal distance between roots (P <0.05) and became more prominently decreasing with the increasing distance from the contact point to the alveolar crest (especially 4, 5, and 6 mm) (P <0.05). CONCLUSION: The results suggest that the interproximal distance between roots and the distance between the contact point and the alveolar crest have an independent and combined effect on the existence of interproximal papillae.     

Fabrication of an adjustable mini‐screw surgical guide

Abstract

Mini‐screws are small enough to be inserted into narrow spaces that could not be used for endosseous implants, such as the alveolar bone between the roots of adjacent teeth. Mini‐screw placement into these sites can be challenging because of the risk of root damage. The present article describes, step by step, how to manufacture an adjustable surgical guide to facilitate the placement of orthodontic mini‐screws, thus reducing the risk of injury to roots and important anatomical structures.     

上颌前突患者后牙区微种植体植入位置的CBCT研究

目的：本研究通过利用锥形束 CT(cone beam computed to－mography,CBCT) 进行扫描重建有上颌前突患者的上下颌骨,进行分析对比微种植体植入后牙区颌骨不同部位骨密度的差异,为临床上能更准确的定位微种植体支抗植入位置方面提供参考。方法：将20例有上颌前突的患者利用锥形束 CT对其口腔颌面部进行扫描及三维重建,在上颌后牙区第二前磨牙与第一磨牙区、第一磨牙与第二磨牙距离牙槽嵴顶 3、5、7、9mm 处,先以近远中向选取上后牙区各牙根间牙槽嵴中心层,再在唇腭向选取矢状面上后牙区距离最外层骨皮质2、4、6mm处进行骨密度的测量,比较不同区域内骨密度的差异。结果：在上颌骨后牙段不同高度同一深度,不同深度同一高度,骨密度值之间的对比均存在统计学差异(P<0.001)。在距离骨皮质相同深度时,距牙槽嵴顶高度为7mm处骨密度值大于其他各组,而在同一高度时,随着深度的增加骨密度值减少。结论：通过CBCT测量分析不同高度与深度植入上颌后牙区的外周骨密度大小,在距离牙槽嵴顶高度为7mm处骨密度值大于其它位置。可以为微种植体植入提供参考。     

Equicrestal and subcrestal dental implants: a histologic and histomorphometric evaluation of nine retrieved human implants

Background: Stability of peri‐implant crestal bone plays a relevant role relative to the presence or absence of interdental papilla. Several factors can contribute to the crestal bone resorption observed around two‐piece implants, such as the presence of a microgap at the level of the implant–abutment junction, the type of connection between implant and prosthetic components, the implant positioning relative to the alveolar crest, and the interimplant distance. Subcrestal positioning of dental implants has been proposed to decrease the risk of exposure of the metal of the top of the implant or of the abutment margin, and to get enough space in a vertical dimension to create a harmoniously esthetic emergence profile. Methods: The present retrospective histologic study was performed to evaluate dental implants retrieved from human jaws that had been inserted in an equicrestal or subcrestal position. A total of nine implants were evaluated: five of these had been inserted in an equicrestal position, whereas the other four had been positioned subcrestally (1 to 3 mm). Results: In all subcrestally placed implants, preexisting and newly formed bone was found over the implant shoulder. In the equicrestal implants, crestal bone resorption (0.5 to 1.5 mm) was present around all implants. Conclusion: The subcrestal position of the implants resulted in bone located above the implant shoulder.     

Immediate transmucosal implant placement in molar extraction sites: a 12-month prospective multicenter cohort study

Aim: To assess the clinical and radiographic outcomes of immediate transmucosal placement of implants into molar extraction sockets. Study design: Twelve‐month multicenter prospective cohort study. Material and methods: Following molar extraction, tapered implants with an endosseous diameter of 4.8 mm and a shoulder diameter of 6.5 mm were immediately placed into the sockets. Molars with evidence of acute periapical pathology were excluded. After implant placement and achievement of primary stability, flaps were repositioned and sutured allowing a non‐submerged, transmucosal healing. Peri‐implant marginal defects were treated according to the principles of guided bone regeneration (GBR) by means of deproteinized bovine bone mineral particles in conjunction with a bioresrobable collagen membrane. Standardized radiographs were obtained at baseline and 12 months thereafter. Changes in depth and width of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results: Eighty‐two patients (42 males and 40 females) were enrolled and followed for 12 months. They contributed with 82 tapered implants. Extraction sites displayed sufficient residual bone volume to allow primary stability of all implants. Sixty‐four percent of the implants were placed in the areas of 36 and 46. GBR was used in conjunction with the placement of all implants. No post‐surgical complications were observed. All implants healed uneventfully yielding a survival rate of 100% and healthy soft tissue conditions after 12 months. Radiographically, statistically significant changes (P<0.0001) in mesial and distal crestal bone levels were observed from baseline to the 12‐month follow‐up. Conclusions: The findings of this 12‐month prospective cohort study showed that immediate transmucosal implant placement represented a predictable treatment option for the replacement of mandibular and maxillary molars lost due to reasons other than periodontitis including vertical root fractures, endodontic failures and caries.     

Probing around implants and teeth with healthy or inflamed peri-implant mucosa/gingiva. A histologic comparison in cynomolgus monkeys (Macaca fascicularis)

The purpose of this study was to obtain a better understanding of probing measurements around osseointegrated oral implants. A comparison was made of probe tip position around Astra Tech implants and teeth of eight cynomolgus monkeys (Macaca fascicularis) in conditions of i) healthy peri-implant mucosa/gingiva, ii) mild mucositis/gingivitis, iii) severe mucositis/gingivitis or iv) peri-implantitis/periodontitis. Histological sections of 128 probes that were attached to implants or teeth with surrounding tissues were prepared by the cutting-grinding technique. No systematic differences were identified in the clinical and histological estimates of the distance between the mucosal/gingival margin and the probe tip. The differences were mainly smaller than 0.5 mm, and in no case were they larger than 0.7 mm. For implants and teeth with healthy peri-implant mucosa/gingiva, the distance between the probe tip and the alveolar bone was similar and ranged from 0.5 to 1.5 mm (P = 0.97). However, the probe tip was closer to bone around implants than around teeth in conditions of mild mucositis/gingivitis (P = 0.034), severe mucositis/gingivitis (P < or = 0.0001) and peri-implantitis/periodontitis (P < or = 0.0001). Around implants with severe mucositis and peri-implantitis, the distance was generally smaller than 0.5 mm, whereas teeth with severe gingivitis and periodontitis showed distances that mainly ranged from 0.5 to 1.5 mm. In conclusion, the probing measurements around osseointegrated oral implants and teeth were different. Even mild marginal inflammation was associated with deeper probe penetration around implants in comparison to teeth.     

前牙区即刻种植和延迟种植软硬组织的保存比较：临床研究

目的：即刻种植被广泛认为是可靠而成功率相当高的治疗方法。主要的优点是：1、缩短疗程;2、保存牙槽骨;3、易于确定种植体位置。拔牙后3-12个月牙槽骨吸收程度最明显。拔牙后即刻种植被认为是保留牙槽骨的最好方法,但是有学者认为拔牙植骨后延迟种植对于美学效果更加可靠。我们总结了上颌前牙区即刻种植和延迟种植的两组病例,对其牙槽骨的变化和软组织变化进行追踪和测量。材料方法：组一：即刻种植拔牙前拍摄,不翻瓣拔牙后行即刻种植,种植系统为NobelBiocare Replace或Ankylos。在种植体骨壁之间填塞Bio-Oss骨颗粒和Bio-Gide胶原膜。仔细关闭伤口,以确保初期愈合。术后6个月拍3D锥形束CT,并开始修复（临时或者永久修复）。组二：延迟种植拔牙同时植入Bio-col骨胶原,3个月后行种植体植入,之后6个月开始临时修复。种植体植入后6个月拍摄3D锥形束CT。结果：通过3DCT观察,两组患者的牙槽骨都得到了比较好的保存,牙龈的边缘水平和牙龈乳头的高度都比较理想。第二组患者在拔牙后和种植后牙龈乳头变圆钝,有不同程度的萎缩现象,但是在临时修复后3个月出现自动恢复的现象。结论：两组患者都显示出美学效果良好,说明这两种方法都可以比较可靠地达到良好的美学效果。即刻种植更显示出缩短疗程的优势;而延迟种植需要更长的治疗时间。我们建议在前牙即刻种植或延迟种植时使用引导骨再生技术,同时使用移植骨材料和隔离膜。在组织稳定性和美学效果的稳定性方面还需要长期的前瞻性临床观察。     

Interproximal tissue dimensions in relation to adjacent implants in the anterior maxilla: clinical observations and patient aesthetic evaluation

Objectives: This clinical study aimed to assess (i) interproximal tissue dimensions between adjacent implants in the anterior maxilla, (ii) factors that may influence interimplant papilla dimensions, and (iii) patient aesthetic satisfaction. Material and methods: Fifteen adults, who had two or more adjacent implants (total of 35) in the anterior maxilla, participated in the study. The study design involved data collection from treatment records, clinical and radiographic assessment, and a questionnaire evaluating aesthetic satisfaction. Results: The median vertical dimension of interimplant papillae, i.e., distance from tip of the papilla to the bone crest, was 4.2 mm. Missing papilla height (PH) at interimplant sites was on average 1.8 mm. Median proximal biologic width at interimplant sites was 7 mm. The most coronal bone‐to‐implant contact at implant–implant sites was located on average 4.6 mm apical to the bone crest at comparable neighbouring implant–tooth sites. The tip of the papilla between adjacent implants was placed on average 2 mm more apically compared with implant–tooth sites. The contact point between adjacent implant restorations extended more apically by 1 mm on average compared with implant–tooth sites. Median missing PH was 1 mm when an immediate provisionalization protocol had been followed, whereas in the case of a removable temporary it was 2 mm. Split group analysis showed that for missing PH≤1 mm, the median horizontal distance between implants at shoulder level was 3 mm. Patient satisfaction with the appearance of interimplant papillae was on average 87.5%, despite a Papilla Index of 2 in most cases. Conclusions: The apico‐coronal proximal biologic width position and dimension appear to determine papilla tip location between adjacent implants. There was a significant association between the provisionalization protocol and missing PH, which was also influenced by the horizontal distance between implants. Patient aesthetic satisfaction was high, despite a less than optimal papilla fill.     

牙龈厚度与上前牙唇侧骨板厚度的相关性研究

目的：测量分析上前牙牙龈厚度与唇侧骨板厚度及牙槽嵴顶到釉牙骨质界距离的相关性。方法：对30位青年受试者用间接显影法进行 CBCT 扫描,测量并记录以下数据并进行统计分析：龈缘下2 mm 牙龈厚度,牙槽嵴顶下2、4、6 mm 骨板厚度,牙槽嵴顶到釉牙骨质界的距离。CBCT 测量的准确性用直接测量法进行检测。结果：牙龈厚度与牙槽嵴顶下2、4、6 mm 处骨板厚度相关系数（r）分别为0．493、0．383、0．342（P ＜0．001）,牙龈厚度与牙槽嵴顶至釉牙骨质界距离相关系数（r）为－0．213（P ＜0．01）。CBCT 扫描法测量与直接测量法之间差异无统计学意义（t ＝－0．521,P ＝0．603）结论：上前牙唇侧中央牙龈厚度与对应牙槽骨骨板厚度正相关,与牙槽嵴顶到釉牙骨质界的距离呈负相关。     

Effect of gingival wall on resistance to probing forces

Abstract This study was conducted to determine whether the gingival tissue lateral 10 the periodontal sulcus contributes resistance to the advancement of a periodontal probe tip into the sulcus under different applied pressures. An electromechanical device was used to advance a probe tip 0.6 mm in diameter into the facial sulcus at a constant speed until resisting forces of 0.70 N were encountered. The device registered the resisting force and probe advancement simultaneously. The gingiva of all 2nd incisors, 2nd premolars, and 1st molars of 4 young adult male beagle dogs were tested. After the first measurement, the buccal gingiva of experimental sites were incised mesiodistally from the gingival margin to the alveolar crest and the sulcus was reprobed. 2 experimental and control quadrants were selected randomly resulting in 6 sets of both experimental and control data from each animal. The data were analyzed with analysis of variance. The analysis demonstrated significant variation from site to site, and dog to dog; therefore, only changes between the 1st and 2nd probings at the same sites could be compared. Less variability of probing distance in different animals occurred at higher forces; however, the incision had a significant effect on probing distance at these forces. The pressure at which probing distance had less variability among animals and least affected when the gingival sulcular wall was incised was estimated to be 106 N/cm². This corresponds to 30 g force on the 0.6 mm diameter probe.